Novel nomogram with microvascular density in the surgical margins can accurately predict the risk for anastomotic leakage after anterior resection for rectal cancer
© 2019 Wiley Periodicals, Inc..
BACKGROUND: Anastomotic leakage (AL) is a serious complication after anterior resection. The purpose of this study was to determine the role of microvascular density (MVD) in AL and to develop a nomogram to accurately predict AL.
METHODS: This study retrospectively enrolled 477 consecutive patients who underwent anterior resection for rectal cancer from January 2011 to January 2019. Tissue samples of the resection margins were assessed for MVD. Univariate and multivariate regression analyses were used to identify the risk factors for AL.
RESULTS: The incidence of clinical AL was 6.7%. MVD in the distal margin was associated with AL (P < .001). Univariate and multivariate regression analysis identified the following variables as independent risk factors for AL: preoperative albumin ≤35 g/L (odds ratio [OR] = 2.511), neoadjuvant treatment (OR = 3.560), location of tumor ≤7 cm (OR = 3.381), blood loss ≥100 mL (OR = 2.717), and MVD in the distal margin ≤20 (OR = 4.265). Then, a nomogram including these predictors was developed. The nomogram showed good discrimination (AUC = 0.816) and calibration (concordance index = 0.816). The decision curve analysis demonstrated that the nomogram was clinically useful.
CONCLUSIONS: MVD in the distal margin is closely associated with AL. The nomogram can be used for individualized prediction of AL after anterior resection for patients with rectal cancer.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:120 |
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| Enthalten in: |
Journal of surgical oncology - 120(2019), 8 vom: 16. Dez., Seite 1412-1419 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Xiao, Chanchan [VerfasserIn] |
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| Links: |
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| Themen: |
Anastomotic leakage |
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| Anmerkungen: |
Date Completed 02.12.2019 Date Revised 08.01.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/jso.25730 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM30227488X |
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| 500 | |a Date Revised 08.01.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 Wiley Periodicals, Inc. | ||
| 520 | |a BACKGROUND: Anastomotic leakage (AL) is a serious complication after anterior resection. The purpose of this study was to determine the role of microvascular density (MVD) in AL and to develop a nomogram to accurately predict AL | ||
| 520 | |a METHODS: This study retrospectively enrolled 477 consecutive patients who underwent anterior resection for rectal cancer from January 2011 to January 2019. Tissue samples of the resection margins were assessed for MVD. Univariate and multivariate regression analyses were used to identify the risk factors for AL | ||
| 520 | |a RESULTS: The incidence of clinical AL was 6.7%. MVD in the distal margin was associated with AL (P < .001). Univariate and multivariate regression analysis identified the following variables as independent risk factors for AL: preoperative albumin ≤35 g/L (odds ratio [OR] = 2.511), neoadjuvant treatment (OR = 3.560), location of tumor ≤7 cm (OR = 3.381), blood loss ≥100 mL (OR = 2.717), and MVD in the distal margin ≤20 (OR = 4.265). Then, a nomogram including these predictors was developed. The nomogram showed good discrimination (AUC = 0.816) and calibration (concordance index = 0.816). The decision curve analysis demonstrated that the nomogram was clinically useful | ||
| 520 | |a CONCLUSIONS: MVD in the distal margin is closely associated with AL. The nomogram can be used for individualized prediction of AL after anterior resection for patients with rectal cancer | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anastomotic leakage | |
| 650 | 4 | |a microvascular density | |
| 650 | 4 | |a nomogram | |
| 650 | 4 | |a rectal cancer | |
| 650 | 4 | |a surgical margin | |
| 650 | 7 | |a Serum Albumin |2 NLM | |
| 700 | 1 | |a Zhou, Meihua |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Xihua |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Fangtao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xiaofei |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Xiaojie |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Huiqiu |e verfasserin |4 aut | |
| 700 | 1 | |a Luo, Jihui |e verfasserin |4 aut | |
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